Abstract PCCLB-46: DELIRIUM AND DEVELOPMENTAL DELAY AMONG CRITICALLY ILL INFANTS AND CHILDREN: A PILOT STUDY

Abstract

Aims & Objectives: To determine whether ICU-delirium among infants and preschool-aged children is associated with long-term developmental impairment (LTDI). Methods This is a prospective pilot study in patients aged 6-months to 5-years admitted to the pediatric ICU regardless of diagnosis. Daily delirium screening occurred for up to 14 days in all patients using the Preschool Confusion Assessment Method for the ICU. Baseline developmental status was determined by primary care physician documentation prior to the critical illness. One year following ICU discharge, parents completed the Ages & Stages Questionnaire (ASQ) and ASQ:Social - Emotional (ASQ:SE). LTDI was defined as any deficit in the ASQ or ASQ:SE. Associations between delirium and LTDI was analyzed using logistic regression, adjusting for baseline developmental delay. Results ASQ and ASQ:SE questionnaires were completed on 59 patients. Median age was 22 months (IQR 11, 41), with 83% (50/59) having a low risk PRISM score and 42% (25/59) requiring mechanical ventilation. Incidence of ICU-delirium was 42% (25/59). Though only 19% (11/59) of patients had baseline developmental delay, 59% (34/59) met LTDI criteria at follow-up. Patients who experienced ICU-delirium were more likely to be delayed in ASQ domains of communication (OR 3.18, 95%CI [0.99, 10.26)] and problem solving (OR 3.37[0.98,11.65]; p=0.05 for both). Global ASQ and ASQ:SE scores were not associated ICU-delirium (OR 2.59[0.77, 8.67]). Conclusions LTDI one year following ICU discharge was highly prevalent among infants and children compared to baseline in this pilot study. ICU-delirium may be an independent risk factor for LTDI, specifically in the domains of communication and problem solving.